Provider Demographics
NPI:1417220716
Name:AIRROSTI PEAK PC
Entity Type:Organization
Organization Name:AIRROSTI PEAK PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:1800-404-6050
Mailing Address - Street 1:911 CENTRAL PKWY N
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-5052
Mailing Address - Country:US
Mailing Address - Phone:800-404-6050
Mailing Address - Fax:210-477-7631
Practice Address - Street 1:36 S 18TH AVE
Practice Address - Street 2:SUITE D
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-2412
Practice Address - Country:US
Practice Address - Phone:800-404-6050
Practice Address - Fax:210-477-7631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-16
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5736111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty